A tracheal tube is a catheter that is inserted into the trachea to establish and maintain a subject's airway. Tracheal tubes are frequently used for airway management in settings of general anesthesia, critical care, mechanical ventilation and emergency medicine. Tracheal tubes can be used to ensure an adequate exchange of oxygen and carbon dioxide, to deliver oxygen in higher concentrations than found in air, or to administer gases to a subject.
An endotracheal tube is a specific type of tracheal tube that is usually inserted through the mouth or nose. It is a breathing conduit designed to be placed into the airway of critically injured, ill or anesthetized subjects in order to perform positive pressure ventilation of the lungs and to prevent the possibility of aspiration or airway obstruction.
Intubation generally refers to the placement of a tracheal tube into the trachea of a subject to maintain an open airway, provide ventilatory assistance, or to serve as a conduit through which to administer certain drugs. Intubation is generally performed in critically injured, ill or anesthetized subjects to facilitate ventilation of the lungs and to prevent the possibility of asphyxiation or airway obstruction.
Methods to confirm proper tracheal tube placement include direct visualization during insertion as the tip of the tracheal tube passes through the glottis or indirect visualization of the tracheal tube within the trachea using a device such as a bronchoscope. If a tracheal tube is properly placed, equal bilateral breath sounds may be heard when listening to the chest of a subject with a stethoscope. This technique may be referred to as an auscultation of the chest. Further, equal bilateral rise and fall of the chest wall will be apparent with ventilatory excursions when the tracheal tube is properly placed into the trachea. If breath sounds are heard when listening to the area over a subject's stomach, this may indicate an improper placement of the tracheal tube into the esophagus. When the tube is properly placed, a small amount of water vapor may be evident within the lumen of the tracheal tube with each exhalation and there should be no gastric contents in the tracheal tube at any time.
Capnography has emerged as an important tool for confirmation of proper tube placement within the trachea. Other methods to detect tracheal tube placement using instruments include the use of a colorimetric end-tidal carbon dioxide detector and transthoracic impedance detection.